Failure of providers to vaccinate HIV-infected men against hepatitis B: a missed opportunity.

Objective: To carry out an audit of hepatitis B immunization practices in an outpatient HIV clinic.

Methods: We reviewed the medical records of all new HIV-infected patients seen between October 1, 1990 and December 31, 1991.

Results: The 125 patients were men with a mean age and CD4 count of 43 yr and 240 cells/mm3, respectively. Fourteen percent (14%) of men who showed a clear need for vaccine, having no HBV markers, were not vaccinated by the clinic staff. Further, 16% whose susceptibility to HBV infection was unclear, with anti-HBc as a sole HBV marker, were not evaluated with a booster dose of hepatitis B vaccine in an attempt to elicit an anamnestic response.

Conclusions: In failing to vaccinate or evaluate the 30% of patients without HBsAg or anti-HBs, our providers are missing an important opportunity in preventive medicine. We urge others to examine their own hepatitis B screening and vaccination practices.